RENR PRACTICE TEST 9

1. The MOST frequent mode of transmission of nosocomial infections is as a result of:

a) Contact transmission
b) Droplet transmission
c) Airborne transmission
d) Vector-borne transmission

2. Which management function is related to the evaluation of the performance of subordinates?

a) Organizing
b) Staffing
c) Directing
d) Controlling

3. Which of the following strategies should be utilized FIRST to minimize resistance to change?
a) Integrate the values and beliefs of the team members in the change.
b) Offer incentives to team members throughout the institution who champion the change.
c) Post information related to the change on the institution’s intranet.
d) Consider implementing the change gradually.

4. In evaluating the effectiveness of intervention for a diagnosis of “less than body requirements” the nurse will
expect to find:
a) Weight gain of 1kg
b) Increase in Hb by 1%
c) Serum albumin >30mg/dl
d) Diminishing sacral oedema

5. Which of the following nurses would the nurse manager recommend for additional training in infection
control?
a) A nurse who wears her mask around her neck between use.
b) A nurse who scrubs her hands for at least 15 seconds during hand washing.
c) A nurse who wears a HEPA style respirator when nursing a client with TB.
d) A nurse who removes her PPE in the order of gloves then gown then mask.

6. Which management theory states that a satisfied employee will perform outstanding work?
a) Behavioral
b) Contingency
c) Neoclassical
d) Classical

7. The most important differences between good leaders and managers is that good leaders:
a) Are born not made.
b) Inspire and motivate.
c) Plan, coordinate and control.
d) Focus on systems and structures.

8. The nurse is obtaining a health history for a client admitted to the hospital after experiencing a brain attack.
Which disorder does the nurse identify as a predisposing factor for an embolic stroke?
a. Seizures
b. Psychotropic drug use
c. Atrial fibrillation
d. Cerebral aneurysm

9. A client with aphasia presents to the emergency department with a suspected brain attack. Which clinical
manifestation leads the nurse to suspect that this client has had a thrombotic stroke?
a. Two episodes of speech difficulties in the last month
b. Sudden loss of motor coordination
c. A grand mal seizure 2 months ago
d. Chest pain and nuchal rigidity
10. The nurse is assessing a client who had a stroke in the right cerebral hemisphere. Which neurologic deficit does
the nurse assess for in this client?
a. Impaired proprioception
b. Aphasia
c. Agraphia
d. Impaired olfaction

11. The nurse is caring for a client who has experienced a stroke. Which nursing intervention for nutrition does the
nurse implement to prevent complications from cranial nerve IX impairment?
a. Turn the client’s plate around halfway through the meal.
b. Place the client in high Fowlers position.
c. Order a clear liquid diet for the client.
d. Verbalize the placement of food on the clients plate.

12. A client who had a stroke is receiving clopidogrel (Plavix). Which adverse effect does the nurse monitor for in
this client?
a. Repeated syncope
b. New-onset confusion
c. Spontaneous ecchymosis
d. Abdominal distention

13. A client has experienced a stroke resulting in damage to Wernickes area. Which clinical manifestation does the
nurse monitor for?
a. Inability to comprehend spoken words
b. Communication with rote speech only
c. Slurred speech
d. Inability to make sounds

14. A 50 year old patient admitted for dehydration needs a complete physical assessment from the nurse. Which of
the following assessment techniques helps the nurse to determine the quality of the turgor of the patient’s skin?
a) Grasping a fold of skin over the sternum.
b) Placing the dorsum of the hand on the skin.
c) Depressing the skin over a bony prominence.
d) Feeling the skin with the palmar surface of the hand.

15. A 25 year old client asks about the cause of anemia in sickle cell disorder. The nurse stated that it resulted
from?
a) Low dietary intake of iron.
b) Poor production of red blood cells.
c) Rapid breakdown of red blood cells.
d) Low intrinsic factor being produced by the stomach.

16. In a “helping relationship” which of the following would the nurse perform?
a) Encourage the patient to explore goals that satisfy personal needs.
b) Identify goals that are set within an inflexible framework.
c) Agree with the patient’s ideas and thoughts.
d) Give the patient personal advice.

17. Which of the following techniques would be the BEST for the nurse when listening to a patient?
a) Avoid unnecessary gestures.
b) Present the conversation from lapsing into silence.
c) Try to identify themes in the patient’s conversation.
d) Stand close to the patient and maintain eye contact.

18. A staff nurse has returned to work after 4 years of being a stay at home mum. The ward sister observes that her
wound care techniques are outdated. What is the MOST appropriate action for the sister to take in this
situation?
a) Select a nurse who will act as her mentor.
b) Refer her to the policy manual on wound care.
c) Seek the opinion of another senior colleague.
d) Recommend the staff nurse for wound care training.
19. The community nurse uses information systems and techniques to collect data about outbreaks of
communicable diseases. The process of ongoing systematic collection analysis and interpretation of the data
that the nurse collects BEST describes the activities of:
a) Tracking
b) Research
c) Investigation
d) Surveillance

20. A 66 year old emaciated chain smoker recently diagnosed with stage III lung cancer is being prepared for
chemotherapy and radiotherapy in planning care for this patient, the nurse should use a:
a) Patient centered approach.
b) Relative centered approach.
c) Collaborative team approach.
d) Interdependent nursing approach.

21. The nurse is teaching bladder training to a client who is incontinent after a stroke. Which instruction does the
nurse include in this clients teaching?
a. Decrease your oral intake of fluids to 1 liter per day.
b. Use a Foley catheter at night to prevent accidents.
c. Plan to use the commode every 2 hours during the day.
d. Hold your bladder as long as possible to restore bladder tone.

22. A client who has a head injury is transported to the emergency department. Which assessment does the
emergency department nurse perform immediately?
a. Pupil response
b. Motor function
c. Respiratory status
d. Short-term memory

An elderly female has learnt that her husband of fifty years has just been admitted to the hospital. She request that
she be told of any changes in his condition immediately. The nurse on the ward learnt that he died soon after the
admission to the hospital. Questions 23 - 24
23. What is the BEST way for the registered nurse to handle the situation?
a) Forewarn her that her husband’s condition has worsened.
b) Take her to the ward and say nothing.
c) Tell her that her husband died just as she got to his bed.
d) Tell her that her husband had died soon after being admitted.

24. Which ethical principle is BEST for the nurse to apply in this situation?
a) Non-maleficence
b) Beneficence
c) Veracity
d) Justice

25. During the nebulization of a sixty-six year old client with chronic obstructive pulmonary disease (COPD) the
rational for using Ipratropium (Atrovent) would be that it is:
a) A bronchodilator and also dries up secretion.
b) Use to treat severe respiratory symptoms.
c) Best tolerated by the elderly.
d) Traditionally used.

26. Which is the MOST appropriate response to a fifty-five year old client with angina who reports keeping some
nitroglycerine (GTN) tablets in a napkin at work?
a) The napkin would keep the GTN tablets dry as it absorbs moisture.
b) Storage in napkin is inappropriate as GTN lose potency in air and light.
c) Having some at work and home is a wise practice and should be encouraged.
d) Having tablets in napkin makes it accessible as no opening of container is necessary.

27. In a client with sickle cell painful crisis, the rational for the use of a warm compress as a nursing intervention is
that it:
 a) Allows the patient to sweat if febrile.
b) Promote vasodilation and enhances tissue perfusion.
c) Increases the thirst sensation and enhances fluid intake.
d) Enhances comfort as the client is use to warm climatic condition.

28. The nurse’s neighbor has been admitted to a ward where the nurse is allocated. A mutual friend meets her in
town and asks about the neighbor’s diagnosis. The MOST appropriate response of the nurse would be:
a) Call me later, I will tell you in private.
b) I’m sorry you will need to ask the patient that yourself.
c) I’m sorry all I can say is that she was admitted for surgery.
d) Perhaps you can ask her sister, she just visited.

29. A client who has just received a positive biopsy test result expresses concern about the possibility of losing her
breast. The MOST appropriate response of the nurse would be:
a) “Don’t worry, you won’t need to have your breast removed.”
b) “You can get a prosthesis, they make some real good looking ones these days.”
c) “Would you like me to refer you to a support group you might consider joining.”
d) “Would you like to consider options other than total breast removal?”

A registered nurse is on duty in the accident and emergency unit when a 10 year old girl is admitted with extensive
abrasions and cuts to her hands and feet and a fractured humerus. The child states that she got the abrasions when
her father beat her with a metal chain then she begs the nurse not to call her father. The adult female who
accompanied the child to the hospital states that she is a neighbor who has witnessed the child’s father beating her
on several occasions. Questions 30 - 32

30. The physician orders that the child’s wounds would be dressed immediately. The law required photographing
of wounds for evidence. Which response by the registered nurse BEST reflects professional standards?
a) “I will dress the wounds as you have ordered.”
b) “I will not dress the wound until photographs are obtained.”
c) “Are you sure that we should dress the wounds prior to photographing?”
d) “Would you dress the wound please? I am required to wait until photographs are obtained.”

31. The police arrived at the hospital and demand that the registered nurse expose the child’s wounds and her
records. The registered nurse can BEST apply legal and professional principles regarding cases of child abuse
by:
a) Asking the police to wait until the child’s wounds are covered.
b) Referring the police to the attending physician in keeping with the hospital policy.
c) Refusing to grant the police access to her records or the child’s privacy.
d) Requesting that a child psychologist be present while the police questions the child.

32. The child was treated successfully and is to be discharged. The nurse recognizes that the health team member
who is MOST central to the child’s discharge planning is the:
a) Psychological as the child would require immediate follow up and trauma counselling.
b) Physician who is the only health team member authorized to discharge patients.
c) Community health nurse to liaise between the hospital and community.
d) Social worker as there is a need for intervention to protect the child.

The registered nurse omitted to immobilize the child’s right arm prior to turning her. The child did not complain
of pain in response, neither was there any obvious complication on initial assessment. Questions 33 – 34.
33. Which ethical principles are MOST applicable in guiding the registered nurse’s response to the nursing care
omission?
a) Paternalism and veracity.
b) Veracity and beneficence.
c) Paternalism and autonomy.
d) Autonomy and beneficence.

34. Which of the following actions taken by the registered nurse BEST reflects professional accountability?
a) Assessing for further injury and immobilizing the child’s right arm.
b) Immobilizing the child’s arm as soon as the omission was discovered.
c) Documenting that the child was turned prior to immobilization of her right arm.
d) Disclosing to the child that the right arm should have been immobilized prior to turning.

35. A client had undergone an amputation of three toes and a femoral-popliteal by-pass. The nurse should teach
the client that after surgery, which of the following leg positions is contraindicated while sitting in a chair?
a) Crossing the legs.
b) Elevating the legs.
c) Flexing the ankles.
d) Extending the knees.

36. In order to prevent deep vein thrombosis (DVT) following abdominal surgery, the nurse should:
a) Restrict fluids.
b) Encourage deep breathing.
c) Assist the client to remain sedentary.
d) Use pneumatic compression stockings.

37. The nurse is administering packed red blood cells to a client. The nurse should first:
a) Discontinue the IV catheter if a blood transfusion reaction occurs.
b) Administer the packed red blood cells through a percutaneously inserted central catheter line with a 20 gauge
needle.
c) Flush packed red blood cells with 5% dextrose and 0.4% normal saline solution.
d) Stay with the client during the first 15 minutes of infusion.

38. The client with acute lymphocytic leukemia is at risk for infection. The nurse should:
a) Place the client in a private room.
b) Have the client wear a mask.
c) Have staff wear gowns and gloves.
d) Restrict visitors.

39. When assessing a client for early septic shock, the nurse should assess the client for which of the following?
a) Cool, clammy skin.
b) Warm, flush skin.
c) Increased blood pressure.
d) Hemorrhage.

40. After completion of peritoneal dialysis, the nurse should assess the client for which of the following?
a) Hematuria
b) Weight loss
c) Hypertension
d) Increased urine output

41. Aluminum hydroxide gel (amphojel) is prescribed for the client with chronic renal failure to take at home.
What is the expected outcome of giving this drug?
a) Relieving the pain of gastric hyperacidity.
b) Preventing Curling’s stress ulcers.
c) Binding phosphate in the intestines.
d) Reversing metabolic acidosis.

42. The nurse is determining which teaching approaches for the client with chronic renal failure and uremia would
be most appropriate. The nurse should:
a) Provide all needed teaching in one extended session.
b) Validate the client understanding of the material frequently.
c) Conduct a one on one session with the client.
d) Use video tapes to reinforce the material as needed.

43. The nurse is instructing the client with chronic renal failure to maintain adequate nutritional intake. Which of
the following diets would be most appropriate?
a) High-carbohydrate, high-protein.
b) High-calcium, high-potassium, high-protein.
c) Low-protein, low-sodium, low-potassium.
d) Low-protein, high-potassium.

44. A patient with chronic renal failure later develops crackles in the lung bases, elevated blood pressure and
weight gain of 2lbs (0.9kg) in one day. Which of the following nursing diagnosis would be PRIORITY for the
patient?
a) Ineffective breathing pattern related to fluid in the lungs.
b) Ineffective tissue perfusion related to interrupted arterial blood flow.
c) Excess fluid volume related to the kidney’s inability to maintain fluid balance.
d) Ineffective therapeutic management related to lack of knowledge about therapy.

45. Which of the following is a long-term complication of peritoneal dialysis?

a) Peritonitis and low back pain.
b) Abdominal hernia and anorexia.
c) Bloody effluent and hemorrhoids.
d) Catheter leakage and high triglycerides.

46. Which of the following legal guidelines is maintained when the client is informed about all alternative
treatments?
a) Confidentiality
b) Informed consent
c) Advanced directives
d) Medication administration

47. An elderly client was placed in the side-lying position after internal fixation for fractures to the right hip.
Which of the following is the BEST reason for placing a pillow or a splint between the legs of the client?
a) Enhances flexion of the knees.
b) Promotes adduction of the thighs.
c) Prevent adduction of the hip.
d) Inhibits hyperextension of the knees.

48. During the interview a diabetic client states that he does not add sugar to his meals but enjoys a large bowl of
frosted cereal in the morning. On further questioning, the nurse identifies that the client is experiencing
difficulty maintaining a diabetic diet. Which of the following actions is PRIORITY in the management of the
patient’s knowledge deficit?
a) Schedule an appointment with the dietician.
b) Discuss the dietary restrictions with the client.
c) Refer to physician of management of insulin.
d) Provide the client with a list of foods to avoid.
49. The nurse would advise a 50 year old client with a type two diabetes mellitus who is on metformin therapy that
the MOST common side effect of metformin is:
a) Weight gain
b) Hypoglycemia
c) Lactic acidosis
d) Respiratory alkalosis

50. A 60 year old client is admitted with a suspected diagnosis of myocardial infarction. An electrocardiogram
was done. Which of the following diagnostic investigations would confirm the diagnosis?
a) Elevated BUN
b) Elevated CK-MB
c) Decreased myoglobin
d) Decreased CK-MM

51. A client is scheduled to undergo grafting to a burn injury to the arm. Which of the following statements by the
nurse should be included in the teaching prior to the procedure?
a) “You will need to report any itching, as it might signal infection.”
b) “Performing the procedure near the end of the hospitalization will reduce the incidence of infection and
improve success of the procedure.”
c) “The procedure will be performed in your room.”
d) “You will begin to perform exercises to promote flexibility and reduce contractures after five days.”

52. An elderly client has been admitted to a medical ward with Do Not Resuscitate status. Which of the following
actions employed by the nurse would demonstrate a respect for client’s right in the event of a cardiopulmonary
emergency?
a) Initiate resuscitation of the client until the doctor arrives.
b) Clarify the client code status before resuscitation.
c) Stay with the client and hold his hand.
d) Page the doctor to certify the death.

53. A nurse discovers that a primary provider has prescribed an unusually large dosage of a medication. Which of
the following is the MOST appropriate action for the nurse to perform?
a) Administer the medication.
b) Notify the prescriber.
c) Call the pharmacist.
d) Refuse to administer the medication.

54. A 66 year old patient with chronic pain in his right hip is sedentary for most of the day. He knows that he
should walk and exercise, but complains that he is in constant pain and is afraid of falling. The nurse selects
the nursing diagnosis of impaired physical mobility. The MOST appropriate nursing intervention is to:
a) Encourage the patient to consider total hip replacement surgery.
b) Teach the patient and his wife how to perform passive range of motion while the patient is sitting.
c) Instruct the patient to take pain medication half hour before walking and use a walker or a cane to provide
stability when he walks.
d) Tell the patient that he needs to walk or he will become bedbound and suggest that his wife assist him.

55. The nurse at an outpatient diabetic clinic is monitoring a client with Type I diabetes mellitus. Today’s blood
work reveals a glycosylated hemoglobin (HbA1c) level of 10%. Which of the following conclusions by the
nurse is justified?
a) A normal value indicating that the client is managing blood glucose control well. No need for additional
teaching plan.
b) A value that does not offer information regarding the client’s management of the disease. Further testing
required.
c) A low value indicating that the client is not managing blood glucose control very well. Create teaching plan.
d) A high value indicating that the client is not managing blood glucose control very well. Create teaching plan.

56. A Hispanic mother who does not speak English and is very upset brings her child to the clinic with bleeding
from the mouth. Which of the following is the MOST appropriate action by the nurse who does not speak
Spanish?
a) Call for the Spanish interpreter.
b) Grab the child and take the child to the treatment room.
c) Immediately apply ice to the child’s mouth.
d) Give the ice to the mother and demonstrate what to do.

57. The client was admitted to the recovery room after having open reduction and internal fixation of his left tibia
and fibula after crash injury. He has a Plaster of Paris (POP) cast in place and he is being nursed with the
affected leg elevated on a pillow. The key of the focused assessment of the client to identify musculoskeletal
complications should include:
a) Vital signs
b) Operation site
c) Intravenous lines
d) Circulatory function

58. To evaluate for complications of crush injury, a client was ordered to have serial urinalysis which would
include reporting:
a) Protein
b) Glucose
c) Bilirubin
d) Leucocytes
59. Complications of crush injury may result in renal failure that is:
a) Intra-renal
b) Pre-renal
c) Idiopathic
d) Post-renal

60. A client’s arterial blood gas results showed pH 7.46, Oxygen (PaO2) 60mmHg, Carbon Dioxide (PaCO2)
30mmHg, Bicarbonate (HCO3) 20mmHg. Those results indicate:
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis

61. What information should a nurse include in a client’s pre-operative teaching?

a) A description of the different postoperative complications that should be prevented.
b) Postoperative plans for pain management especially immediately after surgery.
c) Detailed description of the surgical procedure to be performed on her.
d) Explanation of the potential side effects of the anesthetic to be used.

62. Which of the following outcomes would demonstrate the effectiveness of a client’s pre-operative teaching?
a) She sleeps well the night before surgery.
b) She has a balanced intake and output.
c) She demonstrates deep breathing, coughing, splinting and leg exercises.
d) She remains free of infection as manifested by normal temperature.

63. Which biological factor would contribute to a higher incidence of HIV/AIDS in the female population?
a) Females generally have lower hemoglobin levels.
b) Higher levels of estrogen and progesterone in females.
c) Females produce more lubrication during sexual intercourse, causing virus entry.
d) Structure of the female reproductive organ facilitated entry of the virus.

64. Pre-counselling for HIV testing is done in order to:

a) Teach clients about HARRT.
b) Assure clients of confidentiality of results.
c) Commence procedures for post-exposure prophylaxis.
d) Immediately commence tracing of contacts.

A patient was admitted to the Accident and Emergency Department with burns on the anterior aspects of both
arms and trunk. The physician’s orders included nasogastric tube insertion and intravenous infusion therapy.
Questions 65-70.
65. Using the Rule of Nines, the percentage of burns the patient received is:
a) 18.0%
b) 22.5%
c) 27.0%
d) 37.5%

66. Fluid resuscitation is commenced using the Parkland (Baxter) Formula, with orders to infuse 5 liters within 24
hours. The volume sequence to be infused is:
a) 1000, 1500 then 2500ml
b) 1250, 1250 then 2500ml
c) 1500, 2000 then 1000ml
d) 2500, 1250 then 1250ml

67. The client is diagnosed with deep partial thickness burns. This type of injury affects the:
a) Dermis causing pain.
b) Epidermis and upper dermis causing blisters.
c) Dermis and subcutaneous tissue casing no pain.
d) Epidermis, upper and lower dermis causing blisters.
68. A client who has a severe head injury is placed in a drug-induced coma. The clients husband states, I do not
understand. Why are you putting her into a coma? How does the nurse respond?
a. These drugs will prevent her from experiencing pain when positioning or suctioning is required.
b. This medication will help her remain cooperative and calm during the painful treatments.
c. This medication will decrease the activity of her brain so that additional damage does not occur.
d. This medication will prevent her from having a seizure and will reduce the need for monitoring intracranial
pressure.

69. Inravenous fluid administration is recommended because of the:

a. Extent of the injury
b. Age of the patient
c. Patient’s NPO status
d. Location of the burns

70. The most accurate method used to determine the extent of burnt injuries in the hospital setting is the:
a) Rule of nine
b) Lund and Browdar
c) Rule of Pain
d) Browdar and Brooke

71. The MAIN pathological changes which occur in sickle cell disease are:
a) Gross capillary obstruction and white cell destruction.
b) Marked thrombo-embolic obstruction and tissue necrosis.
c) Increased blood viscosity, capillary fatty streaks and tissue necrosis.
d) Increased blood viscosity, increased cell destruction and tissue necrosis.

The nurse in charge of the medical/surgical unit was granted sick leave for period of one week. A graduate nurse
is assigned to take charge of the unit in her absence. Questions 72 – 75
72. Which of the following actions is of LEAST relevance to the graduate nurse when she is delegating?
a) Organize and evaluate work done.
b) Allocate staff according to their skills.
c) Assign responsibility to complete assignment.
d) Give authority to undertake assigned act.

73. Which of the following activities BEST reflects supervision of staff by the graduate nurse on the unit?
I. Recognizing group needs.
II. Assessing outcomes of care.
III. Planning and organizing work.
IV. Directing and instructing staff.
a) I, II, III
b) I, II, IV
c) I, III, IV
d) II, III, IV

74. Which of the following statements about responsibility would be MOST appropriate to guide the graduate
nurse in managing the unit?
I. Authority may be delegated but responsibility may not.
II. Accountability accompanies responsibility.
III. Responsibility is the amount of power granted by an organization.
IV. Responsibility is an expectation of the level of performance of an individual.
a) I, II, III
b) I, II, IV
c) I, III, IV
d) II, III, IV
75. Which of the following measures should the graduate nurse utilize in order to establish control on the unit?
a) Deciding on priorities.
b) Setting goals and objectives.
c) Reviewing outcomes of patient care.
d) Defining standards of performance.
76. A 70 year old female client is directed by her doctor that she needs surgery but has not been given the
opportunity to seek a second opinion. The ethical principle is:
a) Autonomy
b) Paternalism
c) Beneficence
d) Non-maleficence

77. A 76 year old male client diagnosed with cancer refuses chemotherapy and elect to have natural remedies. The
ethical principle is:
a) Autonomy
b) Paternalism
c) Beneficence
d) Non-maleficence

78. The performance of an emergency tracheostomy of an unconscious elderly client before consent can be
obtained. The ethical principle is:
a) Autonomy
b) Paternalism
c) Beneficence
d) Non-maleficence

79. Ensuring that an older person is not left unattended while in the bathtub for any length of time. The ethical
principle is:
a) Autonomy
b) Paternalism
c) Beneficence
d) Non-maleficence

80. Which of the following assessments would be MOST appropriate during the dwelling phase of dialysis?
a) Observe of urticarial.
b) Check capillary refill time.
c) Monitor electrolyte status.
d) Monitor respiratory status.

81. Which of the following nursing interventions MUST be included in the patient’s plan of care during dialysis
therapy?
a) Limit patient’s visitors.
b) Pad the side rails of the bed.
c) Monitor the patient’s blood pressure.
d) Maintain nil by mouth (NPO) status.

82. The PRIMARY rational for warming dialysis solution prior to use for peritoneal dialysis is to:
a) Add extra warmth to the body.
b) Force potassium back into the cells.
c) Facilitate the removal of serum urea.
d) Promote abdominal muscle relaxation.

83. Three litres of Hartman’s (lactated ringer’s) is charted to flow over 12 hours. The drop factor is 15. The IV has
been running for 9 hours, 800 mls remained. How many drops per minute are needed so that the IV finishes in
the required time.
a) 47 drops/min
b) 57 drops/min
c) 67 drops/min
d) 77 drops/min

84. Which of the following actions is MOST appropriate if the flow of dialysate stops before all the solutions has
drained out?
a) Assist the patient to ambulate.
b) Instruct the patient to sit in a chair.
c) Reposition the peritoneal catheter.
d) Reposition the patient from side to side.
85. A nasogastric tube is inserted because the patient:
a) Is being maintained NPO.
b) Is at risk for gastrointestinal bleed.
c) Will not feel like eating.
d) Needs extra protein to support healing.

86. A patient sustained fractured ribs in a motor vehicular accident. After assessing him, the nurse diagnosed
ineffective breathing pattern. A finding to support this diagnosis would include:
a) Hypoventilation
b) Hyperventilation
c) Rhonchi
d) Decreased air entry

87. A 40 year old patient has been admitted to the ICU after a myocardial infarction. Family history is that the
father died suddenly at age 42. Discharge teaching includes lifestyle modification. The nurse recognize that
teaching was effective when the patient identifies modifiable risk factors as:
a) Diet, inactivity, smoking
b) Diet, smoking, age
c) Diet, inactivity, age
d) Inactivity, smoking, genetics

88. The most appropriate intervention to decrease oxygen demand in a hospitalized patient diagnosed with
myocardial infarction is to:
a) Limit visualization.
b) Limit physical activity.
c) Administer prescribed morphine.
d) Administer supplemental oxygen.

89. In cardiac arrest, the goal of CPR is to prevent:

a) Irreversible injury to the cardiac cells.
b) Irreversible cerebral damage.
c) Pulmonary arrest.
d) Fractured ribs.

Hilda Peters a 31 year old housewife visited her doctor because of nervousness and irritability. Her doctor ordered
the following investigations: Basal metabolic rate (BMR), Protein bound iodine test (PBI), radioactive iodine test,
in order to confirm the diagnosis of Thyrotoxicosis. Questions 90 – 100.
90. The protein bound iodine (PBI) is an important test that aids in the clinical diagnosis of thyrotoxicosis because
it:
a) Determines if the gland is hyperplastic.
b) Reflects the level of circulatory thyroid hormone in the blood.
c) Differentiates between benign and malignant tissue of the thyroid.
d) Determines the rate at which the individual consumes oxygen.

91. Hilda’s PBI and iodine uptake tests will be falsely elevated if she was or had recently been taking medications
containing:
a) Iodine
b) Cortisone
c) Salicylates
d) Sulfonamides

92. In preparing Hilda for her basal metabolic rate examination, it would be inappropriate for the nurse to tell the
patient that she will:
a) Receive a medication before the examination.
b) Fast for approximately 10 hours prior to the examination.
c) Have the examination early in the morning before breakfast.
d) Breathe into a machine for several minutes during the examination.
93. Which of the following assessment techniques would be of least value when the nurse examines Hilda’s
thyroid gland?
a) Palpation
b) Percussion
c) Inspection
d) Auscultation

94. All of the following are typical symptoms of thyrotoxicosis EXCEPT:

a) Anorexia
b) Tachycardia
c) Heat intolerance
d) Fine hand tremors

95. During a physical assessment, Hilda is most likely to report:

a) Dysmenorrhea
b) Metorrhagia
c) Oligomenorrhoea
d) Menorrhagia

96. Which of the following symptoms related to the eyes characterizes exophinalmus?
a) Floating eye balls
b) Protrusion of the eye balls
c) Inability to see in the dark
d) Halos around the eye balls

97. Which of the following symptoms should the nurse teach Hilda to report immediately if it occurs?
a) A sore throat and general malaise
b) Constipation and abdominal distention
c) Painful and excessive menstruation
d) Increase urinary output and itching skin

98. Hilda is scheduled for sub-total thyroidectomy. Potassium iodine in the form of Lugol iodine was ordered for
her. The primary reason for administering this drug is to:
a) Reduce the size of the thyroid gland.
b) Decrease the body’s ability to absorb thyroxin.
c) Increase the body’s ability to absorb thyroxin.
d) Stabilize the thyroid gland.

99. Which of the following measures is most often recommended to prepare Lugols iodine for administration?
a) Pouring it over ice chips.
b) Diluting with water, milk or juice.
c) Disguising it with pureed vegetable.
d) Pouring it into an alcohol based liquid.

100. The item that the nurse will least likely to have in Hilda’s room is an:
a) Tracheostomy set
b) Suctioning set
c) Cut down set
d) Equipment for administering oxygen